Effective surgical treatment of the carotid sinus sindrome.
Elderly patients frequently suffer from dizziness and syncope; however, an underlying disease may not always be identified. Three patients aged 69, 71 and 56, respectively, experienced spells of dizziness and syncope. Massage of the carotid sinus demonstrated the presence of a carotid sinus syndrome (CSS), an abnormal baroreflex response of the carotid sinus that leads to asystole and extreme hypotension. Conventional treatment is generally by insertion of a pacemaker. These patients, however, were referred to the vascular surgery department of our hospital for removal of adventitial layers of proximal portions of the internal carotid artery. Recovery was uneventful; all three are now free of symptoms. CSS should be considered in the differential diagnosis of dizziness and syncope. Surgical denervation of the carotid artery is a valid treatment option, especially in the vasodepressive or mixed type of CSS.
TOOROP
R J
RJ
Department of Surgery, Máxima Medical Centre , Veldhoven, The Netherlands. r.toorop@mmc.nl
SCHELTINGA
M R M
MR
BENDER
M H M
MH
CHARBON
J A
JA
HUIGE
M C
MC
MOLL
F L
FL
BRUIJNINCKX
C M A
CM
D000368:Aged; D017763:Autonomic Denervation; D017704:Baroreflex; D001794:Blood Pressure; D002340:Carotid Artery Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery*; D002343:Carotid Artery, Internal / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D002346:Carotid Sinus / Q000294:innervation / Q000503:physiopathology / Q000601:surgery*; D004562:Electrocardiography; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D013575:Syncope / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D013577:Syndrome; D016896:Treatment Outcome